Ischemic Fasciitis

Definition

Reactive process composed of large ganglion-like cells, fibroblasts and myofibroblasts set in a myxoid stroma usually occurring at areas of pressure over bone

Usually poorly circumscribed, non-ulcerated mass
- May be larger than other fasciitis lesions
  - Range 1-9 cm
Most often in areas of chronic pressure
- Usually shoulder or hip
Central zone of necrotic fat and/or cystic fibrinoid necrosis surrounded by vessels and proliferating fibroblasts
- Hemosiderin and hemorrhage frequent
- Inflammation frequent
  - Usually chronic, occasionally acute
Fibrin may be prominent in degenerate areas or in vessels
Ganglion-like cells may be present in surrounding tissue
- May surround vessels
- Large nuclei may be irregular
- Chromatin may be dense and smudged
- Prominent nucleoli
- Basophilic to amphophilic cytoplasm
- Mitotic figures may be frequent but atypical figures very rare

Richard L Kempson MD
Robert V Rouse MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342

Original posting: March 8, 2008
Last update: December 30, 2008